What does a BMI above the 91st centile suggest ?
What does a BMI above the 98th centile suggest ?
very overweight (clinically obese)
What does a BMI above the 99.6th centile suggest?
What does a BMI below the 2nd centile suggest ?
It is unusual and may suggest under nutrition
What does a BMI below the 0.4th centile suggest?
They are likely to have additional problems and if not already receiving dietetic attention should be referred
Define what obesity is
Obesity is a high body fat content associated with disease risk
Put these obesity health consequences under the title or either short or long-term health consequences:
Premature mortality, CHD risk factors, hypertension, dyslipidaemia, cardiovascular risk, premature morbidity, asthma, sleep apnoea, chronic inflammation, cancer, obesity persistence, socioeconomic, orthopaedic, type 2 diabetes, lower QOL, liver disease
- CHD risk factors
- Sleep apnoea
- Chronic inflammation
- Type 2 diabetes
- Lower QOL
- Liver disease
- Obesity persistence
- Cardiovascular risk
- Premature morbidity
- Premature mortality
Describe the management of childhood obesity
How is BMI calculated ?
BMI = weight (Kg)/ (height (m))2
Appreciate some of the endocrine causes of obesity
- Growth hormone insufficiency
- Hypogonadotrophic hypogonadism
- Excessive corticosteroid administration
What are the 4 examples of inheritable disorders that are associated with obesity ?
- Down’s Syndrome
- Prader-Willi syndrome
- Duchennes muscular dystrophy
- Fragile X
What is fragile X syndrome ?
It is an inherited genetic condition.
- developmental delays, such as taking longer than normal to sit, walk, or talk compared with other children of the same age
- intellectual and learning disabilities, like having trouble learning new skills
- general or social anxiety
- attention difficulties
- social issues, like not making eye contact with other people, disliking being touched, and trouble understanding body language
- difficulty sleeping
What are some of the physcial signs of fragile X syndrome ?
- a large forehead or ears, with a prominent jaw
- an elongated face
- protruding ears, forehead, and chin
- loose or flexible joints
- flat feet
What is prader-willi syndrome and what are some of the symptoms of it ?
A rare genetic condition:
- a constant desire to eat food, which seems driven by a permanent feeling of hunger and can easily lead to dangerous weight gain
- restricted growth, leading to short stature
- reduced muscle tone (hypotonia)
- learning difficulties
- lack of sexual development
- behavioural problems, such as temper tantrums or stubbornness
Appreciate that the main point of obesity treatment is that the individual needs to be willing to change and also that they need to make lifestyle changes such as eating healthier exericising for at least an hour a day etc.
What is Duchennes muscular dystrophy and what are the sypmtoms/signs of it ?
Muscular dystrophies (MD) are a group of inherited genetic conditions that gradually cause the muscles to weaken, leading to an increasing level of disability. One of the most common and severe forms, it usually affects boys in early childhood.
- have difficulty walking, running or jumping
- have difficulty standing up
- learn to speak later than usual
- be unable to climb the stairs without support
- have behavioural or learning difficulties
What is downs syndrome and what causes it ?
Caused by trisomy of chromosome 21
It is a genetic condition which causes some level of learning disability and characteristic physical features.
- reduced muscle tone leading to floppiness (hypotonia)
- eyes that slant upwards and outwards
- a small mouth with a protruding tongue
- a flat back of the head
- below-average weight and length at birth
When should an Anti-obesity drugs (orlistat) be prescribed in adolescents ?
Only be prescribed for severely obese adolescents (BMI >99.6th percentile) with comorbidities attending a specialist clinic.
Should be regular reviews incase of side effects
When can bariatic surgery be considered in adolescents ?
Bariatric surgery can be considered for post-pubertal adolescents with very severe to extreme obesity (BMI >3.5 SD above mean on UK 1990 charts) and severe co-morbidities
What are the key messages from this lecture ?
1 Hour Physical Activity per day
2 Hours (maximum) screen time
3 Balanced meals